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Dermatology - Clinical Medicine IV > Warts > Flashcards

Warts Flashcards

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Dermatology Board Prep flashcards
1
Q

What are the clinical feature of verruca vulgaris?

A

hyperkeratotic, exophytic, dome-shaped papule or nodule

koebnerize

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2
Q

What is the most common location of verruca vulgaris?

A

fingers, dorsal hands, knees, elbows

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3
Q

What do the black dotes mean in verruca vulgaris?

A

thrombosed capillaries

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4
Q

What is koebnerize?

A

look up

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5
Q

What causes verruca vulgaris?

A

HPV 2, 4

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6
Q

What is the pathology of HPV wartz?

A

hyperplasia of epithelium

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7
Q

What does HPV infect?

A

basal keratinocytes of cutaneous and mucosal epithelium

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8
Q

How is HPV transmitted?

A

skin to skin or contaminated objects, wart to unaffected skin

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9
Q

What causes verrucae plana - flat warts?

A

HPV 3, 10

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10
Q

What causes palmoplantar warts?

A

HPV 1

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11
Q

What causes condylomata acuminata - external genital warts?

A

HPV 6, 11, 16, 18, 31

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12
Q

When is peak prevalence of warts?

A

13-16 yo adolescence, can also be younger and older

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13
Q

What percentage of warts resolve in 2 years?

A

75% but not realistic

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14
Q

How do you treat warts?

A

multiple tx, laser, acids, cryotherapy

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15
Q

What is the only FDA approved treatment for genital warts?

A

imiquimod

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16
Q

What are primarily irritating or destructive txs for warts?

A

cryotherapy, salicyclic acid, tretinoin cream, shave removal, adhesive tape, laser

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17
Q

What is the primarily immune stimulating tx for warts?

A

imiquimod, candida antigen (IL), immunotherapy (squaric acid or DCNB)

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18
Q

When do you use the candida antigen?

A

when other things fail

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19
Q

What are the side effects of cryotherapy?

A

PIPA (postinflammatory pigment alteration), scar, pain, blister, nail dystrophy

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20
Q

What are the clinical features of external genital warts?

A

not hard or hyperkeratotic, sessile papules, may be papules or large confluent plaque

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21
Q

Where are genital warts present?

A

external genitalia, perineum, perianal, inguinal fold

22
Q

How do you do cryotherapy?

A

white ring 2-3 mm outside bump 2x

23
Q

Who has the highest incidence of EGW?

A

20-34 yo

24
Q

What are risk factors for EGW?

A

sex at early age, numerous partners, unprotected exposure

25
Q

What is used for prevention of EGW?

A

HPV vaccine

26
Q

What type of HPV infection does immunosuppressed pt get?

A

frequent, persistent, difficult to treat

higher risk of anal squamous cell carcinoma

27
Q

Which of the following tx would you use for genetial warts?

A

cryotherapy, immiquimod, pdophyllin

28
Q

What are the surgical tx for EGW?

A

laster, electrocautery, scissor, shave

29
Q

How does verrucae planae present?

A

skin colored or pink, smooth surfaced slightly elevated

30
Q

Where does verrucae planae occur?

A

dorsal hands, arms, face (exposed surfaces)

31
Q

How does palmoplantar verruca present?

A

thick, endophytic (depressed into skin of soles) papules, mosaic warts –> large plaques –> thick callus over and around wart,

32
Q

Are plantar warts painful?

A

yes when walking

33
Q

What treatments do you start with?

A

ones that minimize side effects and risk of scarring

34
Q

If you have few warts on your hand or foot, how do you treat?

A

salicyclic acid, adhesive tape, cryotherapy, laser

35
Q

If you have few warts on face, how do you treat?

A

cryotherapy, shave (surgical) removal

36
Q

If you have few warts at other sites, how do you treat?

A

cryotherapy and salicyclic acid

37
Q

If you have many hand and foot warts, how do you treat>

A

salicyclic acid, cryotherapy, squaric acid or DCNB laser

38
Q

If you have many face warts, how do you treat?

A

cryotherapy, tretinoin cream

39
Q

If you have many warts at other sites, how do you treat?

A

imiquimod, tretinoin cream, squaric acid or DCNB

40
Q

What is the mechanism of salicyclic acid?

A

keratolytic loosens connections btw keratinocytes, infected with HPV

41
Q

What improves cure rate?

A

combo salicyclic acid and cryotherapy

42
Q

What are the adverse effects of salicyclic acid?

A

erythema, peeling, irritation, maceration (due to occlusion)

43
Q

Approximately what proportion of pt are wart free at 2 years w/o treatment?

A

60%

44
Q

How do you do cryo?

A

two freeze cycles for 30 seconds or more, remove any thick overlying callus is removed

45
Q

Smooth, dome shaped papules with central umbilication in genital area

A

molluscum contagiosum

46
Q

papillomatous, exophytic papules and plaques in genital area

A

external genital warts

47
Q

What are the surgical treatment for EGW?

A

laser, electrocautery, scissor or shave debulking

48
Q

Who is gardasil FDA approved for?

A

M and F 9-29 yo

49
Q

What vaccine is quadrivalent?

A

gardasil

50
Q

What vaccine is bivalent against 16 and 18?

A

ceravix

51
Q

Who is ceravix approved for?

A

females 10-25 (NO MALES)

Dermatology - Clinical Medicine IV (31 decks)

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